纳米炭结合精细被膜解剖法在甲状腺微小乳头状癌术中的应用

目的 探讨纳米炭结合精细被膜解剖法在甲状腺微小乳头状癌手术中的操作技巧及对喉返神经与甲状旁腺的保护效果.方法 对56例甲状腺微小乳头状癌手术均采用纳米炭结合精细被膜解剖法,并回顾性分析低钙血症、喉返神经损伤等临床资料.结果 术中喉返神经均全程解剖显露并保护完好,无喉返神经损伤.术后无永久性低钙血症发生,暂时性低钙血症发生率为7.1％ （4/56）,临床表现均为手足麻木,经补钙后好转,无抽搐,停药后复查血钙正常.结论 纳米炭结合精细被膜解剖法在甲状腺微小乳头状癌术中的应用能最大程度地避免喉返神经、甲状旁腺的损伤.

Application of carbon nanoparticles and meticulous capsular dissection technique in thyroidectomy of thyroid papillary microcarcinoma

Objective To discuss the technique of carbon nanoparticles（CNs）combined with me- ticulous capsular dissection technique in thyroidectomy of thyroid papillary microcarcinoma （ PTMC ） and access their protective effects on recurrent laryngeal nerve （RLN） and parathyroid gland. Methods Fifty- six patients with PTMC underwent thyroidectomy by CNs and meticulous capsular dissection technique. The clinical data of hypocalcemia and RLN injury were retrospectively analysed. Results During the surgery, the RLN was well exposed and protected excellently without any RLN injury. No permanent hypocalcemia occurred and the rate of transient hypocalcemia was 7.1% （4/56）. The clinical manifestation of these ca- ses presented as limb numbness without convulsion. All these patients were treated with calcium supple- ment and recovered with normal blood calcium. Conclusion Application of CNs and meticulous capsular dissection technique in thyroidectomy of PTMC could avoid the damage of RLN and parathyroid gland to the most extent.